POS1398 ASSOCIATION OF FUNCTIONAL SALIVARY TESTS WITH SALIVARY GLAND ULTRASOUND AND BIOPSY IN PATIENTS WITH PRIMARY SJOGREN’S SYNDROME.
Authors: S. Garcia-Cirera, C. Galisteo, S. Retamozo, M. Moreno, E. Casado, E. Costa Moya, J. Gratacos-Masmitja, J. Calvet
Journal: Annals of the Rheumatic Diseases (2022)

Background Salivary gland ultrasonography is useful to assess salivary gland involvement in primary Sjögren Syndrome. Different publications have describes the association between decreases salivary flow and the degree of involvement with ultrasound. Objectives This study aims to assess the association of functional salivary tests evaluated by stimulated and unstimulated salivary flow (SSF and USF) with salivary major gland ultrasound scores (SGUS) and a positive focus score in a minor salivary gland biopsy. Methods A cross-sectional study including 98 subjects fulfilling the ACR-EULAR 2017 classification criteria for pSS. All patients underwent salivary functional tests, an ultrasound of salivary glands and a minor salivary gland biopsy requested as per clinical practice. The ultrasound images were graded using three different scoring systems: De Vita (0-3), Salaffi (0-4) and Omeract (0-3), obtained as the highest score achieved in the four evaluated glands, left and right parotid and submandibular. Positive biopsy was considered if focus score ≥1 Results This study included 98 patients with pSS. We evaluated the different ultrasound scoring systems and each score individually assessed in parotid and submandibular gland with the salivary functional tests. USF is associated with all SGUS independently of the measurement, with a 2.5 ml/15min higher in negative compared to positive SGUS. Similar results were shown for SSF, with a 3 ml/5 min higher in negative compared to positive SGUS (Table 1). We observed no association between USF or SSF and a positive focus score in the minor salivary gland biopsy. Table 1. Association between salivary flows and ultrasound scoring systems. Unstimulated Salivary Flow Stimulated Salivary Flow Ultrasound score Group N(%) Means[95%CI] p-val N(%) Means[95%CI] p-val Vita N 54 (55.1%) 4.076[3.056, 5.096] 0.004 54 (55.1%) 6.745[5.042, 8.447] 0.011 P 44 (44.9%) 1.839 [0.709, 2.969] 44 (44.9%) 3.436[1.550, 5.322] Vita Parotid N 60 (61.2%) 3.886[2.912, 4.861] 0.008 60 (61.2%) 6.575 [4.961, 8.190] 0.011 P 38 (38.8%) 1.784[0.560, 3.008] 38 (38.8%) 3.182 [1.153, 5.210] Vita Submandibular N 55 (56.1%) 4.002[2.986, 5.017] 0.007 55 (56.1%) 6.668[4.977, 8.358] 0.014 P 43 (43.9%) 1.881[0.733, 3.030] 43 (43.9%) 3.458[1.546, 5.370] Salaffi N 52 (53.1%) 4.050 [3.005, 5.095] 0.007 52 (53.1%) 6.754[5.015, 8.493] 0.014 P 46 (46.9%) 1.965 [0.854, 3.076] 46 (46.9%) 3.570[1.721, 5.419] Salaffi Parotid N 58 (59.2%) 3.857[2.861, 4.853] 0.016 58 (59.2%) 6.578[4.931, 8.225] 0.014 P 40 (40.8%) 1.932 [0.733, 3.132] 40 (40.8%) 3.347[1.365, 5.330] Salaffi Submandibular N 54 (55.1%) 4.011[2.985, 5.037] 0.007 54 (55.1%) 6.689[4.982, 8.396] 0.014 P 44 (44.9%) 1.918[0.782, 3.054] 44 (44.9%) 3.505[1.614, 5.395] Omeract N 56 (58.9%) 3.727[2.727, 4.726] 0.01 56 (58.9%) 6.313 [4.612, 8.014] 0.043 P 39 (41.1%) 1.854[0.656, 3.051] 39 (41.1%) 3.574[1.536, 5.613] Omeract Parotid N 61(64.2%) 3.562 [2.598, 4.526] 0.040 61 (64.2%) 6.227[4.599, 7.854] 0.036 P 34 (35.8%) 1.874 [0.582, 3.165] 34 (35.8%) 3.326[1.147, 5.506] Omeract Submandibular N 57 (60.0%) 3.661[2.667, 4.656] 0.028 57 (60.0%) 6.246[4.557, 7.935] 0.052 P 38 (40.0%) 1.903[0.685, 3.120] 38 (40.0%) 3.603[1.534, 5.671] N: Negative, P: Positive Conclusion USF and SSF are associated with SGUS system independently of the salivary gland evaluated but not with positivity in the biopsy, pointing to salivary ultrasound as a good technique to evaluate functionality. Neither USF nor SSF are associated with positivity in the biopsy indicating no link between histology and functionality. Disclosure of Interests None declared